Effects of Health Service Coverage on Students’ Academic Achievement in Central Uganda

Uganda, like many low- and middle-income countries, continues to prioritise education as a key driver of socio-economic development. However, students’ academic achievement remains constrained by health-related challenges, particularly limited access to essential healthcare services. Despite ongoing policy efforts to improve both health and education outcomes, disparities in health service coverage persist across regions and socio-economic groups, with significant implications for students’ learning, attendance, and performance (World Health Organization [WHO], 2020). This study examined the effect of health service coverage on students’ academic achievement in Central Uganda. Specifically, it analysed the influence of accessibility to healthcare services, household income and expenditure on health, and participation in health promotion and disease prevention initiatives on academic outcomes. The study was guided by the Social Ecological Model and the Health Belief Model and adopted a convergent mixedmethods design. Quantitative data were collected using structured questionnaires administered to students, teachers, and school administrators, while qualitative data were obtained through interviews with health workers and school nurses across selected secondary schools. The findings indicate that health service coverage significantly influences academic achievement through multiple pathways. Limited access to healthcare services was associated with increased absenteeism, delayed treatment of illnesses, and reduced classroom engagement. Household income and health expenditure were found to shape access to medical services, thereby reinforcing socio-economic inequalities in academic performance. In addition, participation in health promotion initiatives was positively associated with improved health behaviours, enhanced awareness, and better academic outcomes, although access to such programmes remained uneven. The study concludes that health service coverage is a critical determinant of educational achievement, operating through interconnected socio-economic and institutional factors. It recommends strengthening integrated health and education policies, expanding school-based health services, and developing financial protection mechanisms to improve equitable access to healthcare. These findings underscore the importance of multisectoral approaches in enhancing both health and educational outcomes.